成人脊柱侧凸分型方法与手术治疗策略  

Classification and treatment of adult spinal deformity

作　　者：何守玉 朱锋[1] 邱勇[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,南京210008

出　　处：《中国矫形外科杂志》2014年第9期799-803,共5页Orthopedic Journal of China

基　　金：卫生部公益性行业专项资助(编号:201002018)

摘　　要：近年来,学者们通过应用影像学资料与(或)临床资料提出了多种用于规范成人脊柱畸形治疗策略的分型系统,旨在为更精确地比较不同类型成人脊柱畸形的治疗手段与临床疗效。本文通过回顾分析着重介绍几种成人脊柱侧凸分型系统,包括:成人退变性脊柱侧凸Faldni分型、SRS分型系统、Schwab分型、Scoliosis Research Society-Schwab分型系统,以及退变性腰椎侧凸的冠状面失衡分型等。以探讨不同分型方法对手术策略的指导价值,以及对存在的问题等进行全面概述。由于成人脊柱侧凸在影像学表现、临床症状表现、病理形态以及病理生理方面等关系较为复杂,因此制定出一种能够指导临床治疗的成人脊柱侧凸分型系统依然是脊柱外科领域的一大难题。In recent years, adult spinal deformity （ASD） classification systems have been developed with the goal of providing a framework for an accurate and organized categorization of patients with spinal deformity. The main aim of these classifications is to allow a precise comparison of treatment and outcomes for patients with ASD using a reliable radiographic and/or clinical classification for adult deformity. A literature analysis highlighted the following several classification schemes developed for a- dult scoliosis patients： the Faldini classification system for adult degenerative scoliosis, the Scoliosis Research Society system, the Schwab clinical classification system, the Scoliosis Research Society - Schwab adult spinal deformity classification system, and the coronal imbalance system for degenerative lumbar scoliosis. The aim of the current manuscript was to provide a compre- hensive overview of these current classification schemes for adult scoliosis by describing the clinical development, limits, and po- tential applications of these schemes along with their implications for surgical planning. Owing to the complexity of the relation- ship between the radiographic findings, clinical signs, symptoms, pathomorphology, and pathophysiology of ADS, development of a classification system that will provide physicians with a resource for treatment guidance and decision -making remains one of the biggest challenges in spinal surgery.

关 键 词：成人脊柱侧凸 分型方法 治疗 

分 类 号：R687.3[医药卫生—骨科学]